Archive for March, 2011

On Addictions

March 26th, 2011 by Victoria Peters

Addictions. Alcohol, food, smoking, shopping, gambling…..As human beings we have the capacity to become pathologically attached or addicted to just about anything. Addiction has been on my mind for the past two weeks, not just because several folks have verbalized wanting help with their addictions, but because a giant in the field of addictions, Alan Marlatt, has died. He died suddenly on March 14. I think Alan was the first to study the processes that caused people to relapse, and the first to develop treatment tools to prevent relapse. Stanton Peele (Love and Addiction) has written a tribute to Alan Marlatt which you can read here.

http://www.psychologytoday.com/blog/addiction-in-society/201103/tribute-alan-marlatt

I had the pleasure of meeting Alan in 1989 during an interview for my clinical internship at the University of Washington. He gave a short presentation to us prospective interns which just blew me away. I was not especially interested in specializing in addictions treatment, but had I accepted the UW internship and studied with Alan, I very likely would have become an addictions specialist. His warmth and passion for his subject and his compassion for the people he dedicated his life’s work to simply radiated. It was hard not to be affected by him. Although I do not consider myself a specialist in treating people with severe addictions, my willingness to try with my clients who are struggling with addictions and my respect for them,I owe to Alan. My understanding of how we are all in some way addicted to things that can ultimately harm us as well as our environment, I owe to Buddhist philosophy.

Nowadays, I realize I rarely talk about addictions without summoning one of Alan’s ideas and contributions to the field. Relapse prevention is the main focus for anyone who is striving to break free of an addiction and the troubles that often go with it. My interest in mindfulness dovetails with the key components of relapse prevention. Most relapses or lapses occur in a state of “autopilot” when the addict is not paying attention to their mental, physical, or emotional state and when they are not connected with what is happening in their environment and not even aware of where they are. Lest you think this sounds strange, consider that the majority of people, yes, you and I, are in this state of autopilot most of the time!

Abstinence, total abstinence from the substance or behavior to which one is addicted has for many years been the accepted model of recovery and is common to most 12-step programs. The idea that people can recover from an addiction without total adherence to complete abstinence has been challenged and has placed Marlatt at the center of much controversy in the field. Nevertheless, his research has consistently supported a more moderate approach. Marlatt pioneered the concept of “harm reduction” in addictions treatment. Harm reduction involves taking a broader focus on the overall impact of a person’s addiction on their life and the lives of others, and supporting the behavior changes that reduce harm to self or others. While sustained abstinence, if it could be accomplished would certainly reduce harm, the fact remains that very few addicts achieve it, “and even that small group who do will take time to do so and may relapse periodically,” writes Stanton Peele in his article on harm reduction which you can read here: http://www.peele.net/lib/smart.html.

The “abstinence violation effect” is another of Marlatt’s contributions. The term refers to the guilt and perceived loss of control someone feels when they break a self-imposed rule such as not to smoke or drink or eat something ‘forbidden.’ We’ve all experienced the feeling of resignation that follows indulgence in something we only days or hours ago swore we would not do. Ever notice how much willpower you have at the bottom of a carton of Ben and Jerry’s ice-cream? Tons. Give it a few days. Just one scoop and there you have it, abstinence violation. Might as well eat the whole carton. Now imagine the emotional state that accompanies this behavior, especially if it is involving using a drug. Thoughts like “I don’t deserve to have a good (sober) life” rush through the mind. In a matter of moments, the addict is drinking or drugging “at” themselves with a total lack of self-compassion. Read the following article in Time magazine here about this. I think it applies to most of us.

http://www.time.com/time/health/article/0,8599,1868965,00.html

I expect I’ll write more about these concepts as I read further. I’m going to explore Marlatt’s last book Mindfulness-Based Relapse Prevention for Addictive Behaviors.

As always, I encourage you to post your comments and ideas.

 

 

Mindfulness in the Media

March 16th, 2011 by Victoria Peters

I ran across this ‘youtube’ and blog entry which brings in the challenges of being mindful in our tech-driven society.

http://www.youtube.com/watch?v=17ZrK2NryuQ

Enslaved to the Gadget? Take Back Control of Your Life
http://blogs.psychcentral.com/mindfulness/2011/03/enslaved-to-the-gadget-take-back-control-of-your-life/

Mindfulness and Technology

March 14th, 2011 by Victoria Peters

I ran across this ‘youtube’ and blog post which both illustrate the challenges of practicing mindfulness in today’s tech-saturated society.

http://www.youtube.com/watch?v=17ZrK2NryuQ (please copy and paste to watch)

Enslaved to the Gadget? Take Back Control of Your Life
http://blogs.psychcentral.com/mindfulness/2011/03/enslaved-to-the-gadget-take-back-control-of-your-life/

Everyday Mindfulness

March 12th, 2011 by Victoria Peters

I describe my psychotherapy practice as “Mindfulness Based Therapy.”  It seems the word mindfulness is used across a variety of activities from meditation, stress reduction, eating, sports, art, and of course, therapy. But what does it really mean? Perhaps the clearest definition comes from Jon Kabat-Zinn (of Mindfulness Based Stress Reduction)

“Mindfulness means paying attention in a particular way; on purpose, in the present moment, and nonjudgmentally.

Okay. In this very moment I am aware of feeling a little sleepy and unsure of what I want to write. I am also aware of my desire for more coffee, my thought that it is too late in the afternoon to drink another cup, and the bright sunlight of March, unfiltered by foliage, that’s streaming through the window of my study. I am aware that I want to be outside walking, though not in the wind which I am also aware of. Hmm, I am aware of a number of things. Awareness is not the same thing as mindfulness. In order to shift from awareness to a state of mindfulness, I must choose purposely to hold my attention on one of these things, in just this moment and without judging it as wanted, unwanted, or boring. Can I be with my sleepiness, my uncertainty without trying to “fix” it with coffee and web-surfing? Can I be curious about this mental state?  Can I be okay with not writing about this perfectly, without researching the best way to phrase this idea? Hmm, I notice how my discursive mind wants to get me focused on something else. “Write this after a walk or a nap,” says my avoiding mind. “You are not making any sense,” says my judging mind. I am noticing how uncomfortable it is to write while sleepy, yet just by paying close attention to this experience—without struggling to change or judge it— actually changes the experience.

This is everyday mindfulness. While mindfulness meditation is more structured and formal, everyday mindfulness, in my experience, has the quality of looseness and flow to it. One benefit of meditation is that we get better at everyday mindfulness. We remember to drop into the present moment more frequently. We spend less energy trying to escape what is unpleasant. We become better at resisting the distractions of our thinking mind. Living in this way has the effect of deepening and enriching our daily life.

Have you ever noticed how much you seem to enjoy the simple things when you are vacationing in an unfamiliar place?  Often we notice things around us and we enjoy ourselves more because we are in a frame of mind that invites an expanded awareness. We’re not so much in our heads as we are in the place, in the moment outside of ourselves.  What if we could enjoy this feeling of being on vacation every day? Well, everyday mindfulness, or being tuned into our fabulous sense organs and to the experiences they are delivering to us is a little like being in the vacation mind. Try this. Step outside your home and imagine you have just left the bed and breakfast where you slept last night in this new place you’re staying for awhile. Take a walk and imagine you’ve never been on this street before. Pay attention. See what you notice about the place. Notice how it feels to walk or drive to a café—maybe it’s one you visit often—but today visit it as if for the first time.

Maybe you’re a person who doesn’t much care for vacations or novel places. Okay, try this. As you start your day, take the most mundane activities—showering, brushing your teeth, dressing—and do them mindfully. Pay attention and do each of these activities as if for the first time. Open your senses. Feel the water on your skin, the soft towel on your body as you dry yourself. Notice the smell of the soap or lotion you apply to your body. Notice how the light plays on your skin and see yourself through the eyes of an artist or photographer. Hear the songs of the early spring robins and the flickers as they call to one another outside your bedroom window. Get the idea?  Many years ago, when I was still a teenager, I played a game with myself. I imagined I was a great film director. I viewed everything as if I were making an art film.  It was my way of coping with the boredom I experienced while doing my chores. I suppose it was a mixture of fantasy and mindfulness.

Mindfulness practice, whether it is with meditation or everyday mindfulness activities, is really about changing the way we relate to our experiences. It isn’t just a technique for feeling better about ourselves, it is a way of being, as Jon Kabat-Zinn says, “it’s a way of knowing.”  When we are fully awake to ourselves, when we live in the spirit of openness and kindness to ourselves and others, we can begin to let go of the tug-of-war around changing ourselves and making ourselves “better.”  The paradox of course, is that when we live this way, our lives often do change for the better.

Here is another resource for those of you who wish to read more about mindfulness:

http://mindful.org/

 

 

 

Getting Started with Meditation: part 3

March 6th, 2011 by Victoria Peters

If you want to understand anything more deeply, start teaching it. I am reminded of this wisdom as I continue writing about meditation. This week, as I said in my last post, I started re-reading Turning the Mind Into An Ally by Sakyong Mipham. I still love this book as a primer on meditation from the Shambhala perspective.  I also received my new Kindle e-reader this week which I am enjoying largely because it allows me instant access to more books and blogs than you can imagine.  I subscribed to a blog called Mindfulness and Psychotherapy which you can read for free here: http://blogs.psychcentral.com/mindfulness/. I really like this blog! (If you have a Kindle you can have the entries delivered to it for 99c a month.)  The blogger is a psychologist in West Los Angeles, Elisha Goldstein, Ph.D. who is also the co-author of A Mindfulness Based Stress Reduction Workbook by Bob Stahl.  One of her blogs is an interview with Sharon Salzberg, one of America’s leading mindfulness teachers and authors who has played a significant role in bringing mindfulness practice and lovingkindness practice into the mainstream culture. Sharon has a new book titled Real Happiness which I sampled and promptly downloaded to my Kindle.  I am always on the lookout for accessible books about meditation for beginners. Actually, I think I am still a beginner although I have had a meditation practice for nearly 30 years!  The cool thing about this book is that there is an accompanying blog for a list of folks from various walks of life who participated in the 28-day Meditation Challenge in February. For the month of February a diverse group of people participated in the meditation program that Sharon Salzberg has laid out in her new book. They were asked to reflect on their experiences—pleasant, difficult, and in between—and to communicate about how it was going. They blogged and/or tweeted about their experiences. You can read all of these on Sharon’s website here http://www.sharonsalzberg.com/ .  I think it will be very helpful for any of you who may be contemplating starting a meditation practice to visit her website and read what others—both beginners and more experienced meditators—have written about their experiences during the month of February.

Coming soon… “everyday mindfulness.”

 

Disclaimer

March 6th, 2011 by Victoria Peters

Website Disclaimer

by Victoria J. Peters, Ph.D.

The contents of this site/blog are for informational and educational purposes only. Nothing found on this website is intended to be a substitute for professional psychological, psychiatric or medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified mental health provider with any questions you may have regarding a medical condition or mental disorder. Never disregard professional medical advice or delay in seeking it because of something you have read on this site. If you think you may have a mental health or medical emergency, call your doctor or 911 immediately. Before attempting any treatment plan, regardless of whether it is conventional or not, please consult your psychologist, physician or mental health therapist.

Reliance on any information provided on this website or by any person or professional appearing on this website is solely at your own risk. Dr. Victoria Peters is not liable for any advice or information provided on the site, all of which is provided on an “as-is” basis. No warranties express or implied, are made on the information provided. No representations or warranties are made with respect to the accuracy or completeness of the contents of the information contained in this blog. The fact that an organization, book, or Website is referred to in this blog as a citation and/or a potential source of further information does not mean that the author endorses the information the organization or Website may provide or recommendations it may make. The author is not liable for any damages arising here from.

Opinions expressed within any given blog post by the individual bloggers are their own and do not reflect the opinions of Dr. Victoria Peters. Comments posted by any given visitor are solely the responsibility of that individual blogger. The creator/administrator of the blog does not accept any responsibility for the comments that others post to the blog.

It is expected that those who post comments to blog responsibly and respect other visitors. The site will be monitored regularly, and any posts deemed offensive or that offer dangerous or dubious medical advice will be removed.

 

 

ACT gets the Official "Stamp of Approval'

March 4th, 2011 by Victoria Peters

I just got an update from Steve Hayes of ACBS (The Association of Contextual Behavioral Science):

“Good news. The United States Substance Abuse and Mental Health Services Administration (SAMHSA) has now listed ACT as an empirically supported method as part of its National Registry of Evidence-based Programs and Practices (NREPP).” It is now available on the NREPP Web site at http://174.140.153.167/ViewIntervention.aspx?id=191

“This listing and report has been the work of an entire community over more than three years.”   This is indeed good news.  While I realize that this may not seem like a big deal to many of you, I assure you it is. It is not easy to pass the rigors of SAMHSA. This is the kind of thing that separates, in my opinion, a good solid research based intervention from the latest fad techniques.  So if you are coming to see me and we are using ACT, rest assured, this is effective treatment!

 

 

Meditative Music

March 1st, 2011 by Victoria Peters

What I did instead of watching the Academy Awards last night was to attend a tabla concert at Bas Bleu Theater in Fort Collins. If you have not heard Ty Burhoe perform before, you are missing out on something quite unique and interesting. Last night Ty Burhoe on tabla and Steve Oda on the sarode musically transported their audience through the rhythms and melodies of two classical ragas from Northern India. While I listened deeply to the conversation between tabla and sarode I realized I was in a meditative state. There are many activities in our daily lives that can induce this particular state of mindfulness. Listening to Indian music is one that does this for me.  I am no musicologist and the music from this part of the world is quite foreign to me. In fact the first time I listened to Ravi Shankar I thought it all sounded the same. My Western ear could not discern the subtleties of this music form.

Perhaps it’s the years of meditating that have changed my experience of this music and perhaps it is gaining a little understanding of this art form. Ty does a wonderful job of describing the nature of this music.  Check out his website here: http://www.tyburhoe.com/. Now, when I listen to a raga I am struck by the complexity of this music, which is 95% improvised, as well as by the demand it makes on the listener to be completely in the moment. Each time my mind wanders off, I lose the experience and lapse into my Western ear. Yet when I bring myself back to the moment and this music I experience true euphoria. I think the musicians feel this as well. The expressions on the faces of Ty and Steve as they engaged passionately in their music making with each other sums it up better than all these words.